DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Shibayama & Karasawa, Inc.	DOIID	558615	NAIC NPN	2748729

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/17/2002	6/30/2004
Inactive	Non Resident	Agent	Life	10/17/2002	6/30/2004
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/25/2002	6/30/2004
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	10/25/2002	6/30/2004
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/17/2002	6/30/2004
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/17/2002	6/30/2004
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Health	7/31/2003	6/30/2004
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Life	7/31/2003	6/30/2004

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Thompson-Norlemann, Tazuko	555110	Agent - Health	10/17/2002	6/30/2004
Inactive	Thompson-Norlemann, Tazuko	555110	Agent - Life	10/17/2002	6/30/2004